Lead assembly with flexible portions and method therefor

ABSTRACT

A lead assembly includes an outer insulative body, a conductor, and at least one electrode electrically coupled with the at least one conductor. The outer insulative body extends from a proximal end to a distal end and has an intermediate portion therebetween. A flexible portion for example having a bellows portion is disposed along the lead body.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a division of U.S. patent application Ser. No.10/916,313, filed on Aug. 11, 2004 now U.S. Pat. No. 7,238,883, thespecification of which is incorporated herein by reference.

TECHNICAL FIELD

Leads for conducting electrical signals to and from the heart, and moreparticularly, leads including flexible portions.

TECHNICAL BACKGROUND

Pacemaker leads represent the electrical link between the pulsegenerator and the heart tissue, which is to be excited and/or sensed.These pacemaker leads include single or multiconductors that areconnected to an electrode in an electrode assembly at an intermediateportion or distal end of a pacing lead. A connector is included at theproximal end to form the electrical connection with the pacemaker.

To implant the lead within the patient, the lead is often fedintravenously toward the heart. The lead may be implanted within ortravel through complex or tortuous vasculature. The lead may also needto travel through vasculature having increasingly smaller diameters.However, conventional lead designs may be ill equipped to travel intothe smaller sized vessels of the vasculature, or to make the twists andbends required to get to the desired location within the patient.

There is a need for a lead having a lead body with an ability to travelthrough tortuous vasculature. In addition, there is a need for a leadwith a lead body that has a minimal outer diameter and that minimizestrauma to the tissue.

SUMMARY

A lead assembly is provided including an outer insulative body thatextends from a proximal end to a distal end. At least one conductor isdisposed within the outer insulative body, and at least one electrode iselectrically coupled with the at least one conductor. The lead assemblyfurther includes a flexible portion that has a bellows portion that isdisposed along the outer insulative body.

Several options for the lead assembly are as follows. For example, inone option, the bellows portion forms a hermetic seal between two ormore portions of the insulative body, or the bellows portion is formedof a metal, such as a shape memory metal. In a further option, thebellows portion has an outer edge portion where the outer edge portionforms a spiral helix shape. At least one electrode includes an electrodebellows portion, in one option.

Other options for the flexible portion with the bellows portion relateto the location of the bellows portion along the lead assembly. Forinstance, in one option, the bellows portion is disposed at a proximalend of the outer insulative body, for example, between a connectorterminal end and a portion of the lead body. In another option, theflexible portion is disposed at the distal end of the outer insulativebody. The bellows portion and/or the outer insulative lead body can forma number of different shapes. For example, the bellows portion, in oneoption, is disposed along a helical portion of the outer insulativebody.

In another embodiment, a lead assembly is provided that includes atubular insulative body that extends from a proximal end to a distalend, and at least one conductor that is disposed within the tubularinsulative body. At least one electrode is electrically coupled with theat least one conductor, where optionally the at least one electrodeincludes an electrode undulating portion. The lead assembly furtherincludes an undulating portion that is disposed along the tubularinsulative body. For example, in one option, the undulating portion isdisposed at a proximal end of the tubular insulative body, for example,between a proximal end and a terminal connector. In another option, theundulating portion forms part of the conductor of the lead assembly.

A method is further provided that includes coupling a conductor with atleast one electrode, and disposing the conductor and the least oneelectrode within an insulative body. The method further includescoupling a flexible bellows portion along a portion of the insulativebody. Several options for the method are as follows. For instance, inone option the method of forming a flexible bellows portion includesforming a hermetic seal with the flexible bellows portion. In anotheroption, the location of the flexible bellows portion along theinsulative body can vary. For example, the flexible bellows portion canbe coupled directly adjacent to the at least one electrode, or it can bedisposed at the proximal end of the insulative body, or can be disposedat a distal end of the insulative body. In yet another option, themethod further includes elongating the flexible bellows portion anddecreasing an outer diameter of the flexible bellows portion. In yetanother option, the method further includes compressing the flexiblebellows portion and increasing an outer diameter of the flexible bellowsportion.

These and other embodiments, aspects, advantages, and features will beset forth in part in the description which follows, and in part willbecome apparent to those skilled in the art by reference to thefollowing description and referenced drawings or by practice thereof.The aspects, advantages, and features are realized and attained by meansof the instrumentalities, procedures, and combinations particularlypointed out in the appended claims and their equivalents.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 illustrates a block diagram of a lead assembly constructed inaccordance with one or more embodiments.

FIG. 2 illustrates an elevational view of a portion of a lead assemblyconstructed in accordance with one or more embodiments.

FIG. 3 illustrates an elevational view of a portion of a lead assemblyconstructed in accordance with one or more embodiments.

FIG. 4A illustrates a cross-sectional view of a portion of a leadassembly constructed in accordance with one or more embodiments.

FIG. 4B illustrates a cross-sectional view of a portion of a leadassembly constructed in accordance with one or more embodiments.

FIG. 4C illustrates a cross-sectional view of a portion of a leadassembly constructed in accordance with one or more embodiments.

FIG. 5 illustrates a cross-sectional view of a portion of a leadassembly constructed in accordance with one or more embodiments.

FIG. 6 illustrates an elevational view of a portion of a lead assemblyconstructed in accordance with one or more embodiments.

FIG. 7 illustrates an elevational view of an elongated portion of a leadassembly constructed in accordance with one or more embodiments.

FIG. 8 illustrates an elevational view of a portion of a lead assemblyconstructed in accordance with one or more embodiments.

FIG. 9 illustrates an elevational view of a proximal portion of a leadassembly constructed in accordance with one or more embodiments.

FIG. 10 illustrates an elevational view of a portion of a lead assemblyconstructed in accordance with one or more embodiments.

FIG. 11 illustrates an elevational view of a portion of a lead assemblyconstructed in accordance with one or more embodiments.

DESCRIPTION OF THE EMBODIMENTS

In the following detailed description, reference is made to theaccompanying drawings, which form a part hereof, and in which is shownby way of illustration specific embodiments in which the invention maybe practiced. These embodiments are described in sufficient detail toenable those skilled in the art to practice the invention, and it is tobe understood that other embodiments may be utilized and that structuralchanges may be made without departing from the spirit and scope of thepresent invention. Therefore, the following detailed description is notto be taken in a limiting sense, and the scope is defined by theappended claims.

FIG. 1 illustrates an implantable device, such as a lead assembly 100for use with an energy source such as an electrical stimulator 105. Theelectrical stimulator 105, in one option, is a pulse sensor andgenerator that contain electronics to sense various electrical signalsof the heart and also produce current pulses for delivery to the heart.The pulse sensor and generator also contains electronics and softwarenecessary to detect certain types of arrhythmias and to correct rhythm.

The lead assembly 100 includes a lead body 110 and at least one elongateconductor 120 (FIGS. 4A-4C). The lead body 110 extends from a proximalend 112 to a distal end 114. Disposed at the proximal end 112 of thelead is a connector 113. The terminal connector 113 allows for the leadassembly 100 to be coupled with the electrical stimulator 105. Thedistal end of the lead 114 is disposed along, or disposed within, aportion of the heart 102. The lead assembly 100 further includes atleast one electrode 116 disposed there along. The at least one electrode116 allows for electrical signals to be delivered and/or received fromthe heart 102 and communicated with the energy source, such as theelectrical stimulator.

The lead assembly 100 further includes one or more flexible portions 130disposed there along. In one option, at least one flexible portion 130is disposed at a proximal end 112 of the lead assembly 100. In oneoption, the flexible portion 130 is disposed between the proximal end112 and the terminal connector 113. This allows for the flexible portionto minimize kinking where different tubing or components are used. Theflexible portion 130 further allows for a strain relief between the leadassembly 100 and the energy source. The flexible portion 130, as furtherdiscussed below, allows for additional coupling options for coupling theterminal connector 113 with the remaining portions of the lead assembly100.

In another option, one or more flexible portions 130 are disposed alongthe lead body 110, for example, along an intermediate portion of thelead body 110 (see for example FIG. 3). In one option, the one or moreflexible portions 130 are disposed between two tubing sections of thelead body 110. In yet another option, the one or more flexible portions130 extend along most or the entire lead body, or along only portions ofthe lead body, or along segments of the lead body. For example, the oneor more flexible portions extend from the distal end to an intermediateportion, and terminate for example, near an electrode. In yet anotheroption, the flexible portion is location on the lead along a portionwhere the lead passes the clavicle and first rib area to preventcrushing or kinking of the lead.

In another option, the one or more flexible portions 130 are disposeddirectly adjacent to the electrode 116. In a further option, one or moreflexible portions 130 are disposed at a distal end 114 of the leadassembly 100, for example, only at the distal end 114 of the leadassembly 100. This allows for the lead assembly 100 to remain highlyflexible and/or kink and/or crush resistant near the distal end of thelead assembly 100 without disrupting any of the features along theintermediate portion.

The one or more flexible portions 130 are formed of material that isflexible, and in an option, is conductive. Extending the flexibleportion 130 along the lead assembly 100, the flexible portion 130 canserve as the conductor for the lead assembly 100 in an option, and asfurther described below. This allows for the conductor to behermetically sealed along its longitudinal axis, and can be made smallerthan conventional conductor designs.

FIG. 2 illustrates one embodiment of the lead assembly 100. The one ormore flexible portions 130, in one option, form the lead body along thelength of the lead assembly 100. In one option, the one or more flexibleportions 130 extend between at least a first electrode 116 and a secondelectrode 116. This is advantageous as commonly the electrode is a weaklink in axial strength, sealing, and tube bonding. Some of the featureson the ends of the electrode will bond to the flexible portions. Thisfurther allows for the lead assembly 100 to traverse tortuous paths ofthe human vasculature.

FIG. 3 illustrates another option where the one or more flexibleportions 130 are disposed adjacent to the electrode 116. In an option,the one or more flexible portions 130 and the electrode 116 form asubassembly, where the electrode 116 may or may not be integrally formedwith the one or more flexible portions 130. The subassembly can includecoupling portions 131, where the conductor 120 can be coupled therewith.The conductors 120 can be coupled with an outer portion of the one ormore portions 130, as illustrated in FIG. 3, or with an inner portion ofthe one or more portions 130, as illustrated in FIG. 4A. The conductor120 can be coupled with the flexible portions 130 in a number ofmanners, including, but not limited to a compression fit, weld, swage,or crimp.

The subassembly, including the electrode 116, includes flexible portionson either or both ends of the electrode 116. The lead body 110 isdisposed over a portion of the subassembly allowing for the electrode116 to be exposed. The exposed surface area of the electrode 116 can bemodified, see for example FIG. 4A and FIG. 5, to vary the amount ofexposed surface area.

FIGS. 4A-4C illustrate further options for the flexible portion 130. Inone option, the portion flexible portion 130 extends from under aportion of the lead body 110, to an exposed portion 133, and optionallyagain extends under the lead body 110. The exposed portion 133,optionally formed integrally with the flexible portion 130, forms theelectrode 116 of the lead assembly. The exposed portion 133 can have anon-planar and/or flexible cross-section, for example, as illustrated inFIG. 5. In another option, the exposed portion 133 can have asubstantially planar cross-section, such as similar to a ring electrode,as illustrated in FIG. 4A.

The electrode 116, in a further option, can be formed integrally asdiscussed above, or can be formed separately and coupled with a portionof the flexible portion 130. For example, the electrode 116 canoptionally include coupling features 117 such as threads which arethreadingly coupled with the flexible portion 130, as illustrated inFIG. 4C. The coupling features 117 can be formed as helical featuressuch as threads, or have other cross-sections which allow for thecoupling features 117 to mate with the undulating portion, as discussedbelow.

FIGS. 6-9 illustrate additional variations for the one or more flexibleportions 130. FIGS. 6 and 7 illustrate examples of a flexible portion130 disposed along the lead body 110 that includes an undulating portion134. The undulating portion 134 includes, for example, a series of waveor wave-like structures disposed along the lead body 110 that allows forthe flexible portion 130 to remain flexible. The undulating portion 134can be made from a number of materials, for example, includingconductive material.

It should be noted that the undulating portions 134 can be disposedalong other portions of the lead assembly 100, as further discussedabove. Furthermore, other profiles for the undulating portion 134 can beused as well. For example, the undulating portion can have, but are notlimited to, square shaped, V-shaped, modified square shaped, or modifiedbuttress shaped profiles, where the profiles can be disposed in aspiral, or non-spiral configuration. The pitch of the undulating portioncan be varied to arrive at different stiffnesses or to mate with coilpitches. Furthermore, the outer diameter of the undulating portion 134can be varied longitudinally along the lead assembly, where the outerdiameter varies dimensionally prior to manipulation such as elongationor compression of the undulating portion 134.

In one option, the flexible portion 130, such as the undulating portion134, is defined by an outer dimension in both a stretched or unstretchedposition. For example, the undulating portion 134 is defined by an outerdimension 137 in an unstretched position as illustrated in FIG. 6. Theundulating portion 134 is further defined by an outer diameter 136 whenthe flexible portion 130 is in an elongated or stretched position, asillustrated in FIG. 7. As illustrated in the drawings of FIG. 6 and FIG.7, the outer dimensions 137 and 136 differ in that the outer dimensiondecreases as the flexible portion is elongated. For example, as a leadis explanted from the vasculature, the outer diameter can be reducedthrough use of the flexible portions 130, thereby facilitatingexplantation of the lead from the patient. Alternatively, a sheath,stylet, or catheter can be used to reduce the outer diameter of theflexible portion, and then removed when the electrode or the flexibleportion 130 is in position within the heart or vasculature.

In another option, the flexible portion 130 includes a series offeatures that are elongatable, however, have an outer structure that issimilar to a helical structure, as illustrated in FIG. 8. The helicalportion 135 allows for the coils to be coupled to the flexible portion130, for example, by threading the coils with the helical portion 135.In addition, the helical portion 135, which can be located in a varietyof locations along the lead, can allow for other components to bethreadingly coupled therewith. For example, a terminal end 160 (FIG. 9)of the lead provided with a helical portion 135 discussed above can becoupled, i.e. by threading, with a connector 162 (FIG. 9), or a portionof a pulse generator that includes mating features, where the helicalstructure can be disposed on an inner portion of the mating part, anouter portion of the mating part, or a combination of both. Such helicalmating features can be disposed along other locations of the leadassembly, including, but not limited to the electrode subassemblydiscussed above. The helical features can also mate with othercomponents, such as, coil filars of the conductor, threaded electronics,or lead fixation components.

The one or more flexible portions 130 include a flexible bellows portion132 (FIG. 2). In another option, the flexible portions 130 include anundulating portion 134 disposed along the insulative body 110, whereoptionally the flexible portions 130 are formed of at least in partinsulative material.

In another option, the one or more flexible portions 130 are formed ofelectrically conductive material. For example, the flexible portion canbe formed from one or more metals including, but not limited to,nitinol, Pt, Ti, PtIr. These materials can form base metals, and in oneoption, subsequently coated with other metals or oxides to provideoptimal pacing or sensing characteristics for electrodes. Alternatively,the flexible bellows portion can be formed of a polymer, or a materialcoated with insulative material, such as parylene coated metal. Itshould be noted that the insulative coating can be a partial coating, orcan completely cover the flexible bellows portion. In yet anotheroption, the flexible bellows portion can be formed of shape memorymaterial that can be activated into a predetermined shape by, forexample, heat or current passed to the bellows resulting in heat.

In one option, the flexible portion is formed by plating a material overa dissolvable mandrel, and then removing the mandrel, for example, byetching it away. In one example, copper and/or nickel is plated overaluminum mandrel, and then the aluminum mandrel is etched away. Thematerials that are coated over the mandrel or base material can be doneso by plating, sputtering, and/or vapor deposition. These procedures,among others, allow for the flexible portion to be made highly flexible,and also have a high fatigue resistance. It also allows for the wallthickness to be made quite thin. For example, the wall thickness can bemade, in an option, about 0.0005 to 0.005 inches in thickness.Furthermore, even though the material is thin and quite flexible, thematerial or the flexible portion can be made to have a hermetic sealbetween the tubing sections or as an electrode, as further describedbelow.

FIGS. 10 and 11 illustrate additional options for the lead assembly,where the lead assembly includes one or more flexible portions 130. Theone or more flexible portions includes the options discussed above, suchas, but not limited to, the undulating portions, and the flexiblebellows portions. In an option, the lead assembly is defined in part bya longitudinal axis 165. The longitudinal axis of the assembly is formedinto a three-dimensional shape, such as a helical shape, as illustratedin FIG. 10, where optionally the one or more flexible portions 130 aredisposed therealong, and optionally form part of the electrode. Theelectrode, having the helical shape, and the flexible portion features(i.e. the flexible bellows portion, the undulating portion), allows itto be disposed against interior surfaces of the human vasculature, orcardiac chambers or structures for lead fixation or intimate contactwith myocardial cells. For example, the flexible portion 130 can bedisposed against an inner wall of a vein, artery or heart chamber. Inanother option, the longitudinal axis 165 of the lead assembly is formedinto a two-dimensional shape, such as a J-shape, as illustrated in FIG.11, and one or more of the flexible portions 130 are disposedtherealong. It should be noted that other shapes can be formed to aid inlead fixation or navigation such as sinusoidal, canted, or other two orthree dimensional shapes, and can be preformed into the lead assembly.

A method further is provided herein that includes coupling a conductorwith at least one electrode, and disposing the conductor and the leastone electrode within an insulative body. The method further includescoupling a flexible bellows portion along a portion of the insulativebody, for example, along a proximal or intermediate portion of theinsulative body.

Several options for the method are as follows. In another option, thelocation of the flexible bellows portion along the insulative body canvary. For example, the flexible bellows portion can be coupled directlyadjacent to the at least one electrode, or it can be disposed at theproximal end of the insulative body, or can be disposed at a distal endof the insulative body. In yet another option, the method furtherincludes elongating the flexible bellows portion and decreasing an outerdiameter of the flexible bellows portion. In yet another option, themethod further includes compressing the flexible bellows portion andincreasing an outer diameter of the flexible bellows portion, forexample, for fixating a portion of the lead assembly. The method offorming a flexible bellows portion optionally includes forming ahermetic seal with the flexible bellows portion.

Advantageously, the flexible portions of the lead assembly 100 allowsfor a lead that is more maneuverable within the patient's vasculaturethan, for example, previous rigid cylindrical electrodes or othercomponents that are relatively more rigid. Furthermore, the flexibleportion allows for a hermetic seal to be formed in places wherepreviously it was impossible. For example, in places where a coilconductor was used. Furthermore, the flexible portions allow forportions of the lead assembly to be reduced in outer diameter, forexample, during explantation or implantation within a patient. Thisallows for further ease of navigation throughout the vasculature. Theflexible portion design, for example within use as the electrode, allowsfor use of a longer electrode with a higher surface area.

It is to be understood that the above description is intended to beillustrative, and not restrictive. Although the use of the implantabledevice has been described for use as a lead in, for example, a cardiacstimulation system, the implantable device could as well be applied toother types of body stimulating systems. Furthermore, it should be notedthat the embodiments, and various options described above andillustrated in the drawings, may be selectively combined to formadditional embodiments. Many other embodiments will be apparent to thoseof skill in the art upon reviewing the above description. The scopeshould, therefore, be determined with reference to the appended claims,along with the full scope of equivalents to which such claims areentitled.

1. A lead assembly comprising: at least one tissue stimulating electrodecoupled with a conductor; an insulative body disposed at least partiallyaround the conductor and the at least one tissue stimulating electrode;and a flexible bellows portion coupled along a portion of the insulativebody, the flexible bellows portion being fixed with respect to at leastone of the insulative body, the conductor, or the at least one tissuestimulating electrode.
 2. The lead assembly as recited in claim 1,wherein the flexible bellows portion is sized and shaped to resistkinking of the lead assembly.
 3. The lead assembly as recited in claim1, wherein at least a portion of the flexible bellows portion is formedof at least one of a metal or a polymer.
 4. The lead assembly as recitedin claim 1, wherein the flexible bellows portion is conductive.
 5. Thelead assembly as recited in claim 1, wherein the flexible bellowsportion is at least partially covered in an insulative coating.
 6. Thelead assembly as recited in claim 1, wherein the flexible bellowsportion includes an undulating portion.
 7. The lead assembly as recitedin claim 1, wherein the flexible bellows portion forms a spiral helix.8. The lead assembly as recited in claim 1, wherein the flexible bellowsportion forms a J-shape.
 9. The lead assembly as recited in claim 1,wherein the flexible bellows portion forms a strain relief at a proximalend of the insulative body.
 10. The lead assembly as recited in claim 1,wherein the at least one tissue stimulating electrode includes anelectrode bellows portion.
 11. The lead assembly as recited in claim 1,wherein the flexible bellows portion is disposed at a proximal end ofthe insulative body.
 12. The lead assembly as recited in claim 11,comprising a terminal end, the flexible bellows portion being disposedbetween the proximal end and a terminal end.
 13. The lead assembly asrecited in claim 1, wherein the flexible bellows portion has arelatively decreased outer diameter when the flexible bellows portionhas an elongated configuration.
 14. The lead assembly as recited inclaim 1, wherein the flexible bellows portion forms a hermetic sealbetween two portions of the insulative body.
 15. An apparatuscomprising: at least one tissue stimulating electrode coupled to aconductor, wherein the conductor and the at least one tissue stimulatingelectrode are disposed within an insulative body; and means for couplinga flexible bellows portion along a portion of the insulative body, theflexible bellows portion being fixed with respect to at least one of theinsulative body, the conductor, or the at least one tissue stimulatingelectrode.
 16. The apparatus as recited in claim 15, wherein theflexible bellows portion is configured to resist kinking of theapparatus.
 17. The apparatus as recited in claim 15, wherein theflexible bellows portion comprises an undulating portion.
 18. A methodcomprising: coupling a conductor with at least one tissue stimulatingelectrode; disposing the conductor and the at least one tissuestimulating electrode at least partially within an insulative body; andcoupling a flexible bellows portion along a portion of the insulativebody, the flexible bellows portion being fixed with respect to at leastone of the insulative body, the conductor, or the at least one tissuestimulating electrode.
 19. The method as recited in claim 18, whereincoupling a flexible bellows portion includes forming a hermetic sealwith the flexible bellows portion.
 20. The method as recited in claim18, wherein disposing the conductor and the at least one tissuestimulating electrode within an insulative body occurs after the atleast one tissue stimulating electrode is coupled with the conductor.21. The method as recited in claim 18, wherein coupling the flexiblebellows portion includes coupling the flexible bellows portion directlyadjacent to the at least one tissue stimulating electrode.
 22. Themethod as recited in claim 18, wherein coupling the flexible bellowsportion includes coupling the flexible bellows portion at a proximal endof the insulative body.
 23. The method as recited in claim 22, whereincoupling the flexible bellows portion at the proximal end includescoupling the flexible bellows portion between a terminal connector andthe insulative body.
 24. The method as recited in claim 18, whereincoupling the flexible bellows portion includes coupling the flexiblebellows portion at a distal end of the insulative body.
 25. The methodas recited in claim 18, comprising elongating the flexible bellowsportion and decreasing an outer diameter of the flexible bellowsportion.
 26. The method as recited in claim 18, comprising compressingthe flexible bellows portion and increasing an outer diameter of theflexible bellows portion.